1^st degree tear – this can be a small nick or abrasion. They usually heal themselves and shouldn’t require a stitch. 2^nd degree tear – includes skin and muscle tissue damage. You may require stitches and it usually takes in or around 2 months to recover. An episiotomy is where the perineum is intentionally cut in order to facilitate delivery. An episiotomy involves the same muscle and tissue as a 2^nd degree tear. 3^rd degree tear – third degree tears is a tear or laceration through the perineum muscles and the muscles which surround the anus. Third degree tears can be further sub-divided into 3a, 3b and 3c tears, depending upon how far the injury extends into the anal sphincter:

• 3a: partial tear of the external sphincter involving less than 50% thickness
• 3b: tear of the external sphincter involving more than 50% thickness
• 3c: external and internal sphincter torn

4^th degree tear – a fourth degree tear extends completely through to the anus, tearing the internal and external sphincter and, on occasion, the internal wall of the rectum or bowel.